Most importantly, you help support continued development of this site. The majority of cases of retinotoxicity have occurred in patients that have had a cumulative dose exceeding 1000g of hydroxychloriquine (Plaquenil). This level is reached in about 7 years with the most common daily dose of Plaquenil, 400 mg/day (200 bid). Chloroquine and proguanil anti malaria tablets Plaquenil and cosamine ds Due to the high risk of flare in systemic lupus erythematosus when discontinuing this medication, continued Plaquenil use is advised in these patients during pregnancy. Small amounts of hydroxychloroquine can be found in breastmilk, but international experts indicate this medication is acceptable while breastfeeding. MECHANISM OF ACTION Several risk factors may increase the likelihood of retinal toxicity from Plaquenil such as, age of greater than 60 years, daily dose more than 6.5 mg/kg; use of the drug more than 5 years, obesity, preexisting retinal disease and, renal or liver failure. Question I have heard conflicting information regarding the correct diagnosis for a Plaquenil exam. Should I use high-risk medication as my primary code? Answer When billing Plaquenil examinations, or any other high risk medication exams, it is appropriate to bill the systemic disease or any ocular manifestations as the primary diagnosis. It now solely uses real body weight (rather than ideal body weight) based on new recommendations from a 2014 study (1). Disclaimer: This tool is designed to help eye care professionals better understand the risk the of retinotoxicity from hydroxychloroquine. Please note: This calculator was modified in 9/2015. High risk medication use plaquenil Plaquenil Hydroxychloroquine Uses, Dosage, Side Effects., The Risk of Retinal Toxicity with Plaquenil Plaquenil use in macular degen How to use Plaquenil. Use this medication regularly in order to get the most benefit from it. If you are taking it on a daily schedule, take it at the same time each day. This risk may. Plaquenil Oral Uses, Side Effects, Interactions.. Correct diagnosis for a Plaquenil exam - American Academy.. Plaquenil Hydroxychloroquine - Side Effects, Dosage.. The ICD-10 section that covers long-term drug therapy is Z79, with many subsections and specific diagnosis codes. Because Plaquenil does not have its own specific category, clinicians should use Z79.899—Other Long Term Current Drug Therapy. But getting the right code is just one step in the process of correctly documenting the encounter. Plaquenil is also an antirheumatic medicine and is used to treat symptoms of rheumatoid arthritis and discoid or systemic lupus erythematosus. Important information. Taking Plaquenil long-term or at high doses may cause irreversible damage to the retina of your eye. ICD-9-CM V58.69 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, V58.69 should only be used for claims with a date of service on or before September 30, 2015.